Elsevier

Vaccine

Volume 21, Issues 7–8, 30 January 2003, Pages 596-600
Vaccine

The global value of vaccination

https://doi.org/10.1016/S0264-410X(02)00623-0Get rights and content

Abstract

While most agree that vaccination is one of the most important public health practices, vaccines continue to be underused and undervalued, and vaccine-preventable diseases remain a threat to world health. Perhaps one reason this gap remains is that decision-making generally is made on a vaccine-by-vaccine basis. There has been less attention to the value of vaccination in general. To more clearly identify this value, this paper reviews the cost-effectiveness literature and calculates the annual benefits of vaccination on a global scale.

Introduction

Vaccination is one of the most significant public health interventions in the past century, sparing millions of people from infectious diseases. Each year 130 million children are born, about 30 million of whom have no access to vaccinations. To improve access, this paper reviews the global value of vaccination, the effectiveness of vaccination initiatives, and the necessity of sustaining progress and overcoming the effects of under-valuation of vaccination on a global scale.

Section snippets

Methods

Estimates of vaccine-preventable cases world-wide, vaccine coverage levels, disease incidence, vaccine costs and cost-effectiveness were obtained through in a four-stage process. First, an electronic document search was conducted to obtain online references and statistics from public agencies and academic centres in the US (Centres for Disease Control, GAVI, National Institutes of Allergy and Infectious Diseases, United Nations/UNICEF, World Bank), the UK (Public Health Laboratory Service),

The status of vaccination world-wide

World-wide average vaccination coverage of children under the age of five fell from 80% in 1990 to 74% in 1999. One in four children in the world remains without immunisation against the six diseases initially covered by EPI (measles, polio, pertussis, diphtheria, tetanus and tuberculosis). Moreover if vaccination is undervalued, there may be a lack of adequate investment in research and development for new vaccines to combat the diseases that are prevalent in developing countries: diarrheal

The world-wide benefits of vaccination

Vaccination is a collective activity in the sense that the act of immunising one person can lead to the protection of an entire group of people and can cross boundaries between countries and continents resulting in a global impact. High vaccination rates benefit all as the spread of infection declines [3]. High rates in one country benefit other countries; and high rates in one generation benefit the next generation.

The benefits of smallpox and polio eradication and measles and tetanus control

Economic burden of vaccine-preventable diseases

The rationale for investing in immunisation programs in developing countries is clear. These programs represent a low risk investment in human capital development with a proven impact. They are highly cost effective, have significant economies of scale, and can be financially sustained by developing countries [11]. The World Bank considers that a health care intervention is cost-effective if it buys a year of healthy life for less than the per-capita gross national product (GNP) of the country.

Conclusion

Vaccines are unquestionably one of the most cost-effective public health measures available, yet they are undervalued and under-utilised throughout the world. It is important for international agencies, governments, and health policy makers to keep this preventive measure in the spotlight. Ultimately, it is the global society and future generations that benefit when all countries make the effort to protect their populations from vaccine-preventable diseases.

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